| NPI | 1609235381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4026178) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209013612) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209013612) | |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2026-01-23 |